Endovascular embolization combined surgery for 87 patients with cerebral arteriovenous malformations

AIM To discuss the effect of endovascular embolization combined surgery for cerebral arteriovenous malformations (AVM). METHODS From March 1997 to March 2001, 87 patients were treated by endovascular embolization combined surgery. 79 patients presented with spontaneous intracranial hemorrhage, 4 with headache,4 with seizure. According to Spetzler and Martin grading scale, 9 patients were GradeⅠ, 11 as GradeⅡ, 12 as GradeⅢ, 43 as Grade Ⅳ, and 12 as GradeⅤ. Embolic agent was NBCA. Microsurgery was performed in all patients following the endovascular embolization. RESULTS After nidus endovascular embolizalion, obliteration rate more than 75% of AVM were obtained in 57 patients (66%), that between 50%~70% of AVM nidus were in 22 (25%), and that rate less than 50% of AVM nidus in 8 (9%). The lesion was totally removed in 82 patients (94%) by surgery after embolization, subtotal or incomplete removal was achieved in 5 (6%). After surgery, 3 patients presented with hemiparalysis or aphasia and 1 patient died. Post operative complication rate was 4.6%. CONCLUSION Endovascular embolization combined surgery is a effective method for cerebral AVM with a high cure rate and a low morbidity and mortalily, especially for large AVMs.